State Senate leaders announce bipartisan Medicaid expansion deal

Staff ReportFebruary 06. 2014 2:36PMCONCORD – A bipartisan group of Senate leaders announced a compromise agreement that would bring expanded health insurance coverage to about 50,000 of Granite Staters below 138 percent of the federal poverty level using 100 percent federal funding for the next three years.

Senate President Chuck Morse, R-Salem, disclosing the framework of the new bill Thursday to a Senate committee with Senate Democratic Leader Sylvia Larsen of Concord, said the plan will require three federal waivers, would sunset after three years without continued 100 percent federal contributions and would use private insurance to reach the additional low-income Granite Staters.

Morse called it a "prudent" approach to "take care of those people that need help and give them private health insurance."

Details will be released when the bill is formally introduced next week. Also on board with the plan are Republican Sens. Jeb Bradley of Wolfeboro and Bob Odell of Lempster, and Democrats Lou D'Allesandro of Manchester and Peggy Gilmour of Hollis.

Gov. Maggie Hassan added her support in her State of the State address, drawing long applause from the audience of lawmakers in the House chambers.

"With today's positive step forward," she said, "it's clear that we can work through this together and help working people access critical health coverage."

She thanked leaders not only of the Senate but also of the House for their "steadfast commitment to reaching a compromise.

"Now," the governor said, "let's get this done."

Morse said taxpayers will be protected by including "sunset clauses that will end the program if waivers are not approved or if federal funding drops below 100 percent."

Morse said the timeline, which had been the sticking point in long debate over Medicaid expansion, now has "firm deadlines and a firm approval process, "and a requirement that if for any reason the waiver necessary to implement private insurance is not approved, then the program will end on June, 30, 2015."

"The bipartisan nature of this agreement shows what can happen when we work together to focus on the issues critical to the well-being of our state," Morse said.

Larsen, who appeared before the committee alongside Morse, said the bill "will be the culmination of a long bipartisan process among senators to find agreement on expanding health insurance" for low income Granite Staters.

"We have resolved the lingering issues left over" from a special session last November, which failed to pass Medicaid expansion."

She said "it will be something the state can be proud of.

"At the end of the day this is about expanding coverage for tens of thousands of mostly working, low-income citizens, supporting our providers, helping our state budget and helping our economy," Larsen said.

While some conservatives in the Senate are expected to oppose the bill, Morse said they should not have been caught off guard.

"I think we've been very clear that we've been meeting to talk about this and the reality is that the next step is to draft legislation and put it though a committee process," with a public hearing, Morse said.

"We did not do that in the fall and this time there will be an opportunity for the public to comment," said Morse.

He said he did not view the plan as an expansion of the Medicaid program, for which the state would have had to have contributed "50 cents on the dollar."

"Medicaid would have hurt the state," he said, "because someone else would have to match that 50 cents.

"If we had been debating that, I don't think we'd be at this point right now," Morse said. "What we did go to was a framework that brought in private health care, brought in health insurance policies that pay 150 cents on the dollar and Medicare rates that pay 85 cent on the dollar. Those are all positive things."

He also said the state should "move forward" with an 1115-B waiver process "and change the way we deliver health care in New Hampshire." The federal government considers such waivers for "program flexibility to test new or existing approaches to financing and delivering Medicaid."

Larsen said the plan attains the goal of Medicaid expansion under the Affordable Care Act.

"The goal was to bring in uninsured working adults who could not afford health insurance," said Larsen. "This will accomplish that. It will mean that the almost 50,000 people in our state who are uninsured, working, a cannot afford their insurance, it will shoe them a path to affording their insurance and make available what they need to that they are not going into bankruptcy or fearing bankruptcy when they face a medical crisis."

Morse said that since the federal government offered to share funding with states for Medicaid expansion, "New Hampshire has been concerned the federal government will pull back on the program. The level of detail on that will be in the legislation but that is there to protect our taxpayers."

"You will have another future Legislature voting on how this is performed in the future," he said, "but I think Washington will have a totally different program four years out from now to deal with this.